Lacunae in noncommunicable disease control program: Need to focus on adherence issues!

J Family Med Prim Care. 2017 Jul-Sep;6(3):610-615. doi: 10.4103/2249-4863.214434.

Abstract

Introduction: Chronic non communicable diseases in India have increased in magnitude with earlier onset and more likelihood of complications. Much emphasis is given to early diagnosis and timely treatment. Additionally, tertiary prevention through medication adherence is needed to limit disability and prevent early onset of complications. This study was aimed to assess the magnitude of medication and lifestyle adherence among elderly patients suffering from diabetes and hypertension in rural areas of Punjab.

Methodology: This was a clinic based study in district Fatehgarh Sahib, Punjab. Patients were subjected to regular blood pressure and blood glucose monitoring. Thereafter they were offered free medications through weekly clinic held at Community Health Center, Bassi Pathana. Along with treatment, Public Health Nurse conducted counselling on diet and lifestyle. Frequency and process of taking medications was explained in local language and records duly maintained during visits.

Results: Nearly 70% of study subjects were more than 50 years old. Males constituted 26% of the sample and 60% of subjects were illiterate. Large majority of study subjects did not consumed tobacco (98.08%) or alcohol (89.42%) in past thirty days. In-sufficient physical activity and poor compliance to diet was reported by 10.5% (Males: 7.4%, Females: 11.7%) and 23.5% (Males: 31.5%, Females: 20.8%) subjects. Nearly 46.15% of study subjects reported missing prescribed medications. Nearly 61.54% of study subjects were very sure that they will be able to take medicines as directed by physician.

Conclusion: National Program for Control of Diabetes, Cardio-vascular Disease and Stroke relies on early diagnosis and treatment non- communicable diseases. However, with reported levels of adherence to medication and lifestyle interventions, there is an urgent need of exploring innovative ways to ensure compliance and improve treatment outcomes.

Keywords: Adherence; chronic; disease; geriatric; medication.